Telecommunications providers, consumers and policymakers
should be aware of the strong parallels between wireline residential Internet service
and the individual health insurance marketplace as it existed prior to the market
reforms of the Patient Protection and Affordable Care Act.
Both residential Internet providers – and formerly individual
health insurers -- shared a business model whose success is ironically predicated
on not selling to all potential customers in their market areas. The underlying principle is risk aversion: vendors believe they cannot adequately manage the risk of loss associated with an expanded market. A smaller, more certainly profitable customer base is better than a larger one notwithstanding the potential for greater revenues.
Before the Affordable Care Act
outlawed the practice starting this month, individual health insurers employed
underwriters charged with selecting relatively healthy individuals less
likely to incur high medical costs, refusing to offer coverage those who didn’t
meet specified underwriting standards. Similarly, wireline residential Internet
service providers offer service to one address while declining to serve another
nearby – even as close as quarter of a mile away or less. As individual health
insurers did, these providers reject the latter residences (as well as some
small business sites) as more costly to serve and thus less potentially
profitable. Their infrastructures are engineered and built to accommodate
preferred addresses and redline the rest.
The problem with this business model for individual health
insurers is that medical underwriting limited the size of the pool of individuals
and families who could pay premiums to cover claims costs. Consequently, the
pool and the number of healthy people staying in it shrank to the point it was
on the verge of collapse when the Affordable Care Act was enacted in 2010. The federal
law intervened to head off market failure by requiring health plan issuers to sell
to anyone applying for coverage regardless of medical history or health condition.
The restrictive marketing practices of Internet service
providers bring about a similar problem. Just as insurance pools are more
viable with more people in them, telecommunications networks are more valuable
when more people are on them or able to get on – both for providers and
subscribers. This principle is known as
Metcalfe’s Law. Those
who argue for broader deployment of fiber to the premise (FTTP) Internet infrastructure
carry over the Metcalfe principle to economic activity and education. Greater
numbers of premises with modern Internet access can lead to more online commerce
and business formation. Increased access to information and educational
curricula, similarly, lead to a more informed and better educated society.
As time goes on and these broader benefits – and conversely costs
of not having affordable premises Internet access – become more evident, it
could lead to large scale market reforms such as are now reshaping the individual
health insurance market.